Individual provider Active NPI

Christy McEwen

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1003283227
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP3222112 Issued in FL
Practice address
836 Prudential Dr Ste 1700B
Unit 1
Jacksonville, FL 32207-8344
Phone
(904) 398-0125
Fax
(904) 389-1832
NPI assigned
Aug 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP3222112 FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 1700B
Unit 1
Jacksonville, FL 32207-8344

Mailing address

PO Box 43667
Jacksonville, FL 32203-3667
Phone (904) 398-3760

Other identifiers 1

IdentifierTypeStateIssuer
ARNP3222112OtherFLARNP LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150930002957 FL Practitioner - Nurse Practitioner 5395053961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 276-8500

3030 W Bearss Ave
Tampa, FL 33618-1811
Phone (813) 968-8777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP3222112FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc Nurse Practitioner CurrentSince Aug 21, 2017 Accepting new patients
Inpatient Consultants of Florida Inc CurrentSince Aug 21, 2017 Accepting new patients

Locations

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1003283227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43667",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322033667",
            "telephone_number": "904-398-3760",
            "fax_number": "904-389-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1700B",
            "address_2": "UNIT 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078344",
            "telephone_number": "904-398-0125",
            "fax_number": "904-389-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEWEN",
        "first_name": "CHRISTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP3222112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE",
            "identifier": "ARNP3222112",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.